Róisín Shortall (Dublin North West, Labour)

I thank Deputies Ó Snodaigh and Joan Collins for raising this issue, which is a matter of concern to all local Deputies.

The Aisling Clinic is located in the grounds of the Cherry Orchard Hospital in Ballyfermot. The centre provides a range of integrated addiction services for those affected by substance misuse, in particular, polydrug use. The services available at the clinic include general practitioner, nursing and counselling services; pharmacy; methadone maintenance; needle exchange; and community welfare officer services. The opening hours of the clinic are from 9 a.m. to 7 p.m. between Monday and Friday and from 10 a.m. until 1 p.m. at weekends. At present, 190 people affected by problem drug use attend the Aisling Clinic day programme and 67 attend the evening programme. The services currently operate from a small four bedroom house on the grounds of the hospital. This accommodation is considered inadequate and inappropriate for this number of patients. It is planned to demolish the premises in 2013 to facilitate the construction of premises to accommodate new inpatient child psychiatry services on the site of Cherry Orchard Hospital.

The Ballyfermot primary care centre is nearing completion and the Health Service Executive addiction service has been requested to have a presence on the site by 31 March this year. The area available in the centre is not sufficient for the large number of patients attending the Aisling Clinic. In view of this, a HSE led working group has been established to examine the options available for the delivery of the addiction services elsewhere. The objective of the group is to achieve a seamless transition to the appropriate site. Its membership is comprised of clinic personnel, namely, the pharmacist, nurse, general practitioner, administrator, senior general assistant and rehabilitation worker. The group, which meets twice monthly, is to report back to the area operations manager with recommendations on the available options by the end of April.

I am aware that clients of the Aisling Clinic may be concerned about the implications for their treatment arising from the plans to transfer the service to alternative accommodation. I have been assured by the HSE that the transition to the new arrangements will not result in a disruption of services. The HSE service plan for 2012 envisages that the health of the population will be managed, as far as possible, within a primary care setting. Those with additional or complex needs will have plans of care developed with the local primary care team, which will co-ordinate all care required with specialist services in the community. Notwithstanding developments at the Cherry Orchard Hospital site, we should seek to integrate drug services in primary care. This will be a challenge. However, if a local GP treats a person's ingrowing toenail, there is no reason he or she should not deal with other aspects of a person's care. If a person who requires ongoing care for arthritis also has a problem with addiction, there is no reason he or she should not attend his or her local GP and receive services for both problems, ideally through a primary care team.

The plan contains a specific target on the development of protocols signposting referral pathways between specialist addiction services and primary care services. The location of the addiction service is not the key issue. The central issue is to ensure that clients with alcohol or substance misuse disorders will have access to appropriate interventions and treatment and rehabilitation services. A client centred approach is key to providing a continuum of care to problem drug users to enable them to address their health needs, as well as their general social, housing, educational and employment needs. This integrated approach is also recognised in the report of the national substance misuse strategy steering group which recommends the establishment of a clinical directorate to develop the clinical and organisational governance framework that will underpin treatment and rehabilitation services.

See this speech in context